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Microwave Ablation of Pulmonary Malignancies Using a Novel High-energy Antenna System

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Abstract

Purpose

To evaluate the technical success, safety, and imaging follow-up of malignant pulmonary nodules treated with a novel high-energy percutaneous microwave ablation (MWA) system.

Methods

Between July 2010 and September 2011, a total of 23 patients, 12 men, mean age 68 (range 30–87) years with 29 pulmonary malignancies of median diameter 19 (range 8–57) mm, underwent computed tomography (CT)-guided MWA with a 16G microwave needle antenna enabling power up to 180 W. Technical success was defined as needle placement in the intended lesion without death or serious injury. Adequacy of ablation was assessed at 24 h on contrast-enhanced CT. Circumferential solid or ground glass opacification >5 mm was used to define an ideal ablation. Local tumor recurrence was assessed at 1, 3, and 6 months after ablation on contrast-enhanced CT.

Results

MWA was technically successful in 93 % (n = 27). Mean ablation duration was 3.6 (range 1–9) min. Ten patients (43 %) developed a pneumothorax as a result of the MWA; only 3 (13 %) required placement of a chest drain. Thirty-day mortality rate was 0 %. The mean hospital stay was 1.5 (range 1–7) days. A total of 22 lesions (75 %) were surrounded by ≥5 mm ground glass or solid opacification after the procedure. At a median follow-up of 6 months, local recurrence was identified in 3 out of 26 lesions, giving a local control rate of 88 %.

Conclusion

MWA using a high-power antenna of pulmonary malignancies is safe, technically achievable, and enables fast ablation times.

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References

  1. Dupuy DE (2011) Image-guided thermal ablation of lung malignancies. Radiology 260:633–655

    Article  PubMed  Google Scholar 

  2. Dupuy DE, Zagoria RJ, Akerley W et al (2000) Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol 174:57–59

    Article  PubMed  CAS  Google Scholar 

  3. Gazelle GS, Goldberg SN, Solbiati L, Livraghi T (2000) Tumor ablation with radio-frequency energy. Radiology 217:633–646

    PubMed  CAS  Google Scholar 

  4. Dupuy DE, Goldberg SN (2001) Image-guided radiofrequency tumor ablation: challenges and opportunities—part II. J Vasc Interv Radiol 12:1135–1148

    Article  PubMed  CAS  Google Scholar 

  5. Ahmed M, Liu Z, Afzal KS et al (2004) Radiofrequency ablation: effect of surrounding tissue composition on coagulation necrosis in a canine tumor model. Radiology 230:761–767

    Article  PubMed  Google Scholar 

  6. Oshima F, Yamakado K, Akeboshi M et al (2004) Lung radiofrequency ablation with and without bronchial occlusion: experimental study in porcine lungs. J Vasc Interv Radiol 15:1451–1456

    Article  PubMed  Google Scholar 

  7. Akeboshi M, Yamakado K, Nakatsuka A et al (2004) Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol 15:463–470

    Article  PubMed  Google Scholar 

  8. Lee JM, Jin GY, Goldberg SN et al (2004) Percutaneous radiofrequency ablation for inoperable non-small cell lung cancer and metastases: preliminary report. Radiology 230:125–134

    Article  PubMed  Google Scholar 

  9. Lencioni R, Crocetti L, Cioni R et al (2008) Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial. The RAPTURE study. Lancet Oncol 9:621–628

    Article  PubMed  Google Scholar 

  10. Simon CJ, Dupuy DE, Mayo-Smith WW (2005) Microwave ablation: principles and applications. Radiographics 25(Suppl 1):S69–S83

    Article  PubMed  Google Scholar 

  11. Skinner MG, Iizuka MN, Kolios MC, Sherar MD (1998) A theoretical comparison of energy sources—microwave, ultrasound and laser—for interstitial thermal therapy. Phys Med Biol 43:3535–3547

    Article  PubMed  CAS  Google Scholar 

  12. Carrafiello G, Mangini M, De Bernardi I et al (2010) Microwave ablation therapy for treating primary and secondary lung tumours: technical note. Radiol Med 115:962–974

    Article  PubMed  CAS  Google Scholar 

  13. Feng W, Liu W, Li C et al (2002) Percutaneous microwave coagulation therapy for lung cancer. Zhonghua Zhong Liu Za Zhi 24:388–390

    PubMed  Google Scholar 

  14. Wolf FJ, Grand DJ, Machan JT, DiPetrillo TA et al (2008) Microwave ablation of lung malignancies: effectiveness, CT findings, and safety in 50 patients. Radiology 247:871–879

    Article  PubMed  Google Scholar 

  15. Vogl TJ, Naguib NNN, Gruber-Rouh T et al (2011) Microwave ablation therapy: clinical utility in treatment of pulmonary metastases. Radiology 261:643–651

    Article  PubMed  Google Scholar 

  16. Anderson EM, Lees WR, Gillams AR (2009) Early indicators of treatment success after percutaneous radiofrequency of pulmonary tumors. Cardiovasc Intervent Radiol 32:478–483

    Article  PubMed  Google Scholar 

  17. National Cancer Institute (2010) Common terminology criteria for adverse events (CTCAE), version 4.0. http://evs.nci.nih.gov/ftp1/CTCAE/About.html

  18. Yasui K, Kanazawa S, Sano Y et al (2004) Thoracic tumors treated with CT-guided radiofrequency ablation: initial experience. Radiology 231:850–857

    Article  PubMed  Google Scholar 

  19. Brace CL, Hinshaw JL, Laeseke PF et al (2009) Pulmonary thermal ablation: comparison of radiofrequency and microwave devices by using gross pathologic and CT findings in a swine model. Radiology 251:705–711

    Article  PubMed  Google Scholar 

  20. Simon CJ, Dupuy DE, DiPetrillo TA et al (2007) Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology 243:268–275

    Article  PubMed  Google Scholar 

  21. Allen MS, Darling GE, Pechet TTV et al (2006) Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the randomized, prospective ACOSOG Z0030 trial. Ann Thorac Surg 81:1013–1019

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Ewan M. Anderson.

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Little, M.W., Chung, D., Boardman, P. et al. Microwave Ablation of Pulmonary Malignancies Using a Novel High-energy Antenna System. Cardiovasc Intervent Radiol 36, 460–465 (2013). https://doi.org/10.1007/s00270-012-0465-2

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  • DOI: https://doi.org/10.1007/s00270-012-0465-2

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